Health Committee on Sept. 13th, 2017

[Doug Eyolfson, Liberal, Charleswood—St. James—Assiniboia—Headingley, MB]

Thank you very much.

Dr. de Villa, we talked about impaired driving due to cannabis. I agree. Certainly, not just in my experience talking with my patients but going back to when I was in high school in the 1970s—yes, I'm that old—there was a belief that there was nothing wrong with driving on it. There were people I knew who would smoke it, and they swore that their video game scores improved after smoking up, so driving must be okay. People have always believed that nonsense.

We know that there have been a lot of ads on drunk driving, and by a lot of metrics they have been pretty effective in getting the message across. In particular, MADD, Mothers Against Drunk Driving, have had some very powerful and effective ads. Are we overdue in getting the same message about driving while impaired on cannabis into these ads and perhaps putting that in the same context? Might that have a bit more credibility now that we're dealing with a legal product, the way we are with alcohol?

[Dr. Eileen de Villa]

I would like to think so. As I mentioned in my remarks, injury and motor vehicle accidents related to that are the main contributor to the burden of illness associated with cannabis right now in this country.

Might those education campaigns help? Yes, I think that's part of it. A whole series of elements are required in an education campaign, impaired driving being one of them. You've heard from other witnesses here that in fact there are other topics of conversation, like trying to ensure that our young people do understand that the earlier they start and the more they use, the more likely they are to suffer longer-term consequences.

By the same token, I think we heard from my colleague here to the left that there is a lot of use among youth. As is the case with virtually every drug, we have to ask how we adopt a preventive approach and, where it is being used, how we adopt a harm reduction approach minimizing the harms associated with the use of that substance, whatever it is, at both the individual level and ultimately the social level.

[The Chair, Liberal, Bill Casey]

The time is up.

Ms. Gladu.

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

Thank you, Chair, and thank you to all of our witnesses today.

My colleague, Mr. Davies, read to you some of the purposes of the legislation, the more important ones being the protection of the health of young persons by restricting their access to cannabis, and providing access to a quality-controlled supply of cannabis. We've been looking and listening to testimony to try to find best practices to keep cannabis out of the hands of our young people.

The State of Washington said that their data shows now, with what they've implemented, that young people are having a harder time getting a hold of cannabis. What they did was merge their medical and recreational marijuana supply systems, so that it's controlled, age-restricted, and tracked. They've only allowed home growing for medical purposes.

My question is for Dr. Fischer. Do you think that this current legislation, which allows home growing, is going to provide a quality-controlled product that will stay out of the hands of younger people?

[Dr. Benedikt Fischer]

Since you're asking me that question so directly, I'll tell you that in my opinion the home-growing provision is one of the worst pieces of the current legislative draft, for several reasons. I think it's a very bad idea for public health, because we should not rely on private homes for the production of psychoactive substances.

Second, there are adverse potential health consequences to other people in the home—everyone in the home, as a matter of fact. This includes a lot of non-users, but also vulnerable people like children, parents, or spouses.

Third, it's probably the safest way to ensure possible diversion of cannabis from what is otherwise supposedly a regulated and restricted market.

Fourth, the home is probably—unfortunately, the former Toronto police chief is not here anymore—the most difficult environment for authorities to control and regulate, at least in our society.

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

Absolutely.

[Dr. Benedikt Fischer]

Overall, home growing is probably the worst or the most inappropriate place for cannabis to be produced. We should leave that to licensed production, distribution, and retail outlets.

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

I fully agree.

Dr. de Villa, knowing that home grow operations are 24 times more likely to have a fire, and knowing that the Ontario Provincial Police have already testified that they are going to have great difficulty trying to enforce this, would you agree that the home-grow option is probably the least preferred way of making sure that we keep cannabis out of the hands of our children?

[Dr. Eileen de Villa]

I don't know that it's the least preferred way with regard to that specific goal, but I agree with my colleague, Benedikt Fischer, that this is not an ideal or optimal provision within the context of the legislation. It's rife with difficulties, for sure, on a series of levels. Whether it does anything with respect to access by youth, clearly, we prefer a publicly regulated, well controlled, and well monitored method of distribution. That is the right way to manage it.

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

Very good, thank you.

Dr. Levy, I was very interested when you talked about tobacco and its stigmatization, because it brought to mind the fact that tobacco was already legal, and an age of consumption was established. It did nothing to prevent people from smoking at alarming rates. It was really that public awareness campaign to change public opinion that was most effective.

I'm interested in what your thoughts are on doing a similar thing for cannabis. Obviously, we've been talking about legalizing it for two years, and we haven't had that public awareness campaign. Could you expand on that?

[Dr. Sharon Levy]

I think that a critical component of the public health strategy has to be our campaign to get out the real message about marijuana. As we heard earlier in the testimony, there is a lot of cultural traction around the message that marijuana is safe, harmless, natural, and legal.

I'll tell you, in my experience, the state where I practise, which is Massachusetts, has recently passed legalization as well. Kids come in now and say, “Well, I know it's not that bad, because it's legal.” There's a lot of work that needs to be done there. “Safe” and “legal“ don't mean the same thing.

I think that because of where we are with marijuana, we can use tobacco as an analogy. It's legal. It's not safe. It's not healthful. It doesn't cause any overdoses, but that doesn't mean that it's safe for consumption. I think making those comparisons is really critical. It is important to have children, their parents, and the other adults who interact with them understand this and to give very clear messages.

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

Thank you very much. I think my time is up.

[The Chair, Liberal, Bill Casey]

Your time is up.

Mr. McKinnon.

[Ron McKinnon, Liberal, Coquitlam—Port Coquitlam, BC]

Thank you, Chair.

Dr. Maté, my riding is Coquitlam—Port Coquitlam in the Lower Mainland. As a Lower Mainland resident, I'm well aware of your long advocacy and as a force for good in this area, so I'd like to welcome you in particular for joining us today. I particularly appreciate your insight and clarity of testimony.

I note that our government has invested $5 billion in budget 2017 to provide mental health support, including for 500,000 people under 25. This goes to prevention, I would suggest to you. In your model that you propose for addiction, many of the underlying causes are psychological and psychiatric problems. I would ask if you think that significant funding for mental wellness programs and funding for early diagnosis of mental illness conditions would be worth doing, and whether it's an effective prevention mechanism.

[The Chair, Liberal, Bill Casey]

Dr. Maté, can you hear me? We can't hear you; we've lost the sound.

My understanding is that we're not going to be able to get the sound back. I would like to say thank you very much for your participation. It's been very enlightening, sharing your knowledge and experience. I'm sorry we can't finish up.

Mr. McKinnon, you still have some time.

[Ron McKinnon, Liberal, Coquitlam—Port Coquitlam, BC]

I'm going to defer to any of my colleagues who may have a question. I was ready with some great questions.

I'll pass.

[The Chair, Liberal, Bill Casey]

For the last question I`ll recognize Mr. Davies. As usual, you always bring up the end.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you.

Dr. de Villa, you issued a report on approaches to protect health and minimize harms of use. You noted how the criminalization of cannabis and possession impacts the social determinants of health. You pointed out that people arrested and convicted of pot possession can face long-term consequences, including their access to employment and housing, their economic status, and social stigmatization. You pointed out that this disproportionately affects young Canadians and racialized and marginalized communities. You also pointed out that, based on current rates—this was back in June—59,000 people will be arrested and 22,000 will be convicted for simple possession of cannabis before this legislation comes in, and you called for an immediate decriminalization to now start addressing those concerns. Is that still your position?

[Dr. Eileen de Villa]

Yes, it is. As I mentioned, we're talking about long-term consequences associated with personal possession.

Dr. Maté, before his unfortunate sound issues, was talking about many of the social problems and the social factors that drive lots of these things. I think, in fact, creating new social harms does not make sense.

[Don Davies, NDP, Vancouver Kingsway, BC]

Now Bill C-45—I've used this term before—legalizes to some degree, but it's not full legalization; it'll be less illegal. There will still be criminal penalties for possession of over 30 grams, for growing over four plants, and for selling. If a 20-year-old sells to a 17-year-old, they're subject to criminal sanctions.

Would you agree with me that Bill C-45 continues to risk disproportionate harm to marginalized and racialized communities by continuing essentially a criminalized approach to some forms of cannabis?

[Dr. Eileen de Villa]

I think that certainly exists, but there is some question as to how legislation is implemented in reality. There's what's on paper, and then there's what happens in practice. I would agree with you that there is still some potential for that, but as I understand it, this is an initial foray, and in fact there are other areas that are not being regulated under the existing legislation that may subsequently be regulated, and presumably other elements might also be....

[Don Davies, NDP, Vancouver Kingsway, BC]

Let me move quickly to that other area in my limited time, because edibles and other concentrates are not covered by this legislation, and I believe you have recommended that those products be regulated. As pointed out by Ms. Hasheminejad, the lesson from Colorado is that people prefer to obtain their products from legal sources. If we keep edibles, concentrates, and other products in the black market, then this bill will not meet its full potential.

What is your position on whether Bill C-45 should include edibles and concentrates in the legalized regulated frame?

[Dr. Eileen de Villa]

In my comments I talked about how I think this is a reasonable approach for now, and that we should continue to move forward and think about and ensure that we're capitalizing on the experiences of other jurisdictions. It's a question of trying to balance it out, so I agree that people prefer to have access to legal products. The question is how you implement that in a fashion that maximizes the public health principles and minimizes harm and increases public safety. It's always, as I think many of our other colleagues commented, a delicate balancing act, but I am supportive of regulating these products so that we can ensure that public health principles are those that are governing these products and their use.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you.

Thank you, Mr. Chair.

[The Chair, Liberal, Bill Casey]

Okay, thanks very much.

That brings to a close our panel for today. Again, I want to thank all of our panellist, on behalf of the committee members, for sharing your information, your knowledge, and your experience with us.

I want to acknowledge our video conference participants, Dr. Le Foll and Dr. Levy. It's difficult to do what you've done today and we appreciate your patience with us and sharing your time with us.

Again, thanks to everybody. You've contributed a lot to our study. You've participated in Bill C-45, and we appreciate it very much.

With that, I'm going to end the meeting, but I just want to say that we're having a fifth panel tomorrow night at six o'clock, from six to eight. The last panel on Friday is moved to tomorrow night.